- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,715.35 / $5,623.41
| Facility | | $1,862.09 | $3,715.35 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $363.08 / $1,122.02
| Professional | | $257.04 | $363.08 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,677.35 / $33,884.42
| Facility | | $645.65 | $4,677.35 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $416.87 / $1,995.26
| Professional | | $251.19 | $416.87 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $3,311.31 / $3,311.31
| Professional | | $562.34 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $912.01 / $6,456.54
| Facility | | $831.76 | $912.01 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $407.38 / $724.44
| Professional | | $223.87 | $407.38 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $707.95 / $7,079.46
| Facility | | $251.19 | $707.95 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $371.54 / $549.54
| Professional | | $263.03 | $371.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $457.09 / $707.95
| Professional | | $251.19 | $457.09 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $4,677.35 / $5,623.41
| Facility | | $1,288.25 | $4,677.35 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,677.35 / $33,884.42
| Facility | | $645.65 | $4,677.35 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $416.87 / $1,995.26
| Professional | | $257.04 | $416.87 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,890.45 / $11,220.18
| Facility | | $1,071.52 | $3,890.45 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $389.05 / $758.58
| Professional | | $251.19 | $389.05 | $758.58 |